Red flags Flashcards

1
Q

name some red flag pathologies

A

myelopathy
cervical artery dysfunction (CAD)
malignancy
systemic inflammatory disorders e.g. RA
DVT
infections
Fractures
Cauda equina syndrome

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2
Q

What is myelopathy?

A

a term used to describe any neurologic deficit related to the spinal cord

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3
Q

What is myelopathy usually due to?

A

compression of the spinal cord

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4
Q

Where does myelopathy occur?

A

It is most commonly localised in the cervical spine but it can also occur in the thoracic and lumbar spine

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5
Q

Name some common symptoms of myelopathy

A

muscle weakness
altered muscle tones
sensory loss (in trunks and legs) and spasticity
impaired coordination
gait disturbances
spinal pain
urinary disturbances

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6
Q

What is cervical artery dysfunction?

A

an umbrella term used to cover a range of vascular pathologies which may lead to cervico-cranial ischaemia

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7
Q

How does CAD present?

A

presentations range from pain, through to cranial nerve dysfunctions, blindness, stroke or at worst death

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8
Q

Name some risk factors of CAD

A

previous trauma to Cx spine
migraine type headaches
HTN
High cholesterol
cardiac disease/vascular disease
diabetes
blood clotting disorders
anti-coagulant therapy
long term use of steroids
history of smoking
recent infection
immediately post-partum
absence of plausible mechanical explanation of symptoms

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9
Q

When does cancer occur?

A

when normal cells change such that they divide and grow in an uncontrolled way, forming malignant tumours

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10
Q

What is local spread?

A

When cancer cells spread to nearby area by pushing their way into healthy parts of the body and potentially damaging them

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11
Q

what are secondary tumours also known as?

A

metastases

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12
Q

What happens if metastatic spinal cord compression is not caught early?

A

It can lead to permanent paralysis from the level of the compression

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13
Q

What patients does MSCC most commonly occur in?

A

Patients with lung, breast or prostate cancer, lymphoma and multiple myeloma

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14
Q

Where is the most common site of MSCC?

A

thoracic spine followed by lumbosacral spine

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15
Q

What are the general signs and symptoms of MSCC?

A

Non mechanical pain
constant night pain
unexplained weight loss
general fatigue or feeling unwell
previous history of cancer
night sweats
unusual lumps/bumps/swelling

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16
Q

What does DVT stand for?

A

deep vein thrombosis

17
Q

What is DVT?

A

a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis

18
Q

Name some symptoms of DVT

A

pain
swelling
redness
enlarged veins in the affected area

19
Q

What is inflammation?

A

a biological response to stimuli interpreted by the body to have a potentially harmful affect

20
Q

What is an inflammatory disorder?

A

where the immune system mistakenly attacks your bodys own cells or tissues

21
Q

What can inflammatory disorders result in?

A

chronic pain
redness
swelling
stiffness
damage to otherwise healthy body tissues

22
Q

What is rheumatoid arthritis?

A

Systemic autoimmune disease characterised by inflammatory arthritis with extra-articular involvement

23
Q

What happens with RA?

A

synovium is infiltrated by immune cells
fibroblasts and inflammatory cells lead to osteoclast generation resulting in bone erosion and loss of joint integrity

24
Q

Name some risk factors of RA

A

genetic factors
smoking
air pollution
obesity
low vitamin D

25
Q

Name some commonly affected joints for RA

A

elbow
shoulder
hip
knee
ankle
MTP

26
Q

How can RA be managed?

A

Goal of treatment is symptom management
pharmacological management - disease modifying anti-rheumatic drugs
Nutrition
physiotherpay

27
Q

When does an infection occur?

A

an infection occurs when a foreign organism enters the body or multiplies in a harmful way

28
Q

What are some risk factors for infections?

A

taking steroids or other medications that supress your immune system, such as anti-rejection drugs for a transplanted organ
HIV or AIDS
having a certain type of cancer or other disorders that affect your immune system
open surgery
poor nutrition
stress
lack of sleep

29
Q

What do the signs and symptoms of an infection depend on?

A

the type of disease

30
Q

Name some signs of infection

A

fatigue
loss of appetite
weight loss
fevers
night sweats
chills
aches and pains
swelling
pus formation
increased temperature

31
Q

Name some risk factors for fractures

A

age and gender
smoking
diabetes
alcohol
RA
Trauma
steroid use
other systemic diseases

32
Q

What is RED-S?

A

Relative energy deficiency in sport is a syndrome in which disordered eating (or low energy availability) and decreased bone mineral density (osteoporosis and osteopenia) are present

33
Q

What is RED-S caused by?

A

eating too little food to support the amount of energy being expended by an athlete, often at the urging of a coach or other authority figure who believes that athletes are more likely to win competition when they have an extremely lean body type

34
Q

Name some signs and symptoms of RED-S

A

dull pain along the bone which can increase with activity
potential mild swelling around the affected area
tenderness around the affected area

35
Q

How can RED-S be managed?

A

treatment is often multidisciplinary requiring a general practitioner, a dietician and a physiotherapist for stress fracture
in addition there is a potential for a sports psychologist to be required if RED-S syndrome is the primary factor for the stress fracture

36
Q

What is the cauda equina?

A

the spinal cord usually terminates terminates between the L1 and L2 vertebra forming the conus medullas, emerging from this bundle of lumbar and sacral roots called the cauda equina

37
Q

What does the nerves of the cauda equina serve?

A

sphincter muscle
sexual function
perineal sensation
sensation
motor functions throughout the lower limbs

38
Q

What are some red flag signs and symptoms for cauda equina?

A

saddle anaesthesia
back pain
bladder dysfunctions
bowel dysfunction

39
Q

What are the causes of cauda equina syndrome?

A

herniated lumbar intervertebral disc
epidural abscess
spinal epidural hematoma
diskitis
tumor
trauma